It ’s About Paramedic Intubation Skill Maintenance, Not ETI vs. SGA

In this study, for all-comers, that was an abysmal 6%. This is an important number because it tells us that overall, successful resuscitation from cardiac arrest is rare and that a number of our efforts may have some statistically significant differences but the absolute effect on the gold standard outcome is rather small. But that’s a story for another time. The focus here is on airway management in cardiac arrest, and the suggestion that the “verdict is out” on whether or not paramedics should be using an endotracheal tube or a supraglottic device.
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Airway & Respiratory Exclusive Articles Source Type: news

Related Links:

This article addresses the uses of videolaryngoscopy, the range of available videolaryngoscopes, the technique of videolaryngoscopy, use of awake videolaryngoscopy and the documentation of videolaryngoscopic intubation.
Source: Trends in Anaesthesia and Critical Care - Category: Anesthesiology Source Type: research
AbstractWith different videolaryngoscopes for pediatric patients available, UEScope can be used in all age groups. The aim of this study was to compare the Miller laryngoscope and UEScope in pediatric intubation by paramedics in different scenarios. Overall, 93 paramedics with no experience in pediatric intubation or videolaryngoscopy performed endotracheal intubation in scenarios: (A) normal airway without chest compressions, (B) difficult airway without chest compressions, (C) normal airway with uninterrupted chest compressions, (D) difficult airway with uninterrupted chest compressions. Scenario A. Total intubation succ...
Source: European Journal of Pediatrics - Category: Pediatrics Source Type: research
Endotracheal intubation has for many years been recognized as the gold standard for airway management [1]. However, as with any procedure, it requires appropriate training [2]. The average learning curve for direct laryngoscopy as shown by studies of Buis et al. is about 50 endotracheal intubations [3]. Studies by Aghamohammadi et al. have shown that the learning curve for videolaryngoscopy is much shorter than for direct laryngoscopy [4]. However, due to the high cost of a videolaryngoscope, standard laryngoscopes with Miller or Macintosh blades are the main type of devices used for endotracheal intubation in the operatin...
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Source Type: research
Conclusion The PART study’s aim was to demonstrate that SGA is superior to SETI. Whether this is true or not remains to be seen. That doesn’t mean this study doesn’t have value. It clearly demonstrated that an important, time-honored and gold standard skill in resuscitation isn’t being practiced effectively by paramedics. The solution should not be to abandon the procedure. The solution is that we need to fix the problem. We need to enhance education, provide more opportunity for skills maintenance and develop systems that ensure that paramedics are regularly practicing these advanced skills. It is ...
Source: JEMS Special Topics - Category: Emergency Medicine Authors: Tags: Airway & Respiratory Exclusive Articles Source Type: news
Publication date: Available online 8 September 2018Source: Air Medical JournalAuthor(s): John Glasheen, Jeff Hooper, Andrew Donohue, Bronwyn Murray-Smith, Emmeline FinnAbstractObjectiveTraumatic cardiac arrest (TCA) has been associated with poor outcome, but there are survivors with good neurological outcome. Treatment of hypoxia plays a key part in resuscitation algorithms, but little evidence exists on the ideal method of airway management in TCA.MethodsLifeFlight Retrieval Medicine is an aeromedical retrieval service based in Queensland, Australia. Data regarding all intubations performed over a 28-month period were acc...
Source: Air Medical Journal - Category: Emergency Medicine Source Type: research
This study had several important limitations. The EMS agencies that participated in this trial have many years of experience in OHCA research, including additional training on CPR quality performance. As previously noted, due to limitations in funding, we couldn’t assess the influence of CPR quality. We studied a relatively limited number of out-of-hospital and in-hospital adverse events. It also wasn’t possible to blind EMS providers to treatment assignment. Although randomization was uneven in two sites, the overall characteristics of the study groups were similar. We observed a lower than expected ETI succes...
Source: JEMS Special Topics - Category: Emergency Medicine Authors: Tags: Airway & Respiratory Exclusive Articles Source Type: news
Authors: Szarpak L Abstract INTRODUCTION: According to the American Society of Anesthesiologists, the incidence of difficult intubation in the operating room is 1.2-3.8%; however, in emergency conditions, this rate is higher and reaches even 5.3%. Successful emergency airway management is an essential component of the modern practice of medicine. Areas covered: The aim of the study is to review the literature regarding different devices used to perform endotracheal intubation (Macintosh, Miller, and McCoy laryngoscopes; ETView, GlideScope, TruView, Airtraq, McGrath MAC, Pentax AWS, Trachlight, Shikani, and Bullard)...
Source: Expert Review of Medical Devices - Category: Medical Devices Tags: Expert Rev Med Devices Source Type: research
Publication date: Available online 30 June 2018 Source:Wilderness & Environmental Medicine Author(s): Alison Matthews Airway management in the wilderness runs the gamut from basic airway support to endotracheal intubation. Fortunately, direct laryngoscopy is a seldom called upon skill in expedition medicine. However, the medical skills required during a mission or expedition are never truly known in advance. Improvisation during evolving medical events is a mainstay of expedition medicine education and practice. It is unlikely, given constraints of weight and size of expedition medical kits, that a conventional laryng...
Source: Wilderness and Environmental Medicine - Category: Environmental Health Source Type: research
Tracheal intubation in emergency medicine is considered one of the most difficult procedures [1,2]. Due to the inability to obtain anesthesia anamnesis or as in the case of cardiopulmonary resuscitation, the need to protect the airway during chest compression or with a minimum pause in chest compression. However, according to studies by Ladny et al. [3,4], or Szarpak et al. [5], the effectiveness of the first intubation attempt using direct laryngoscopy is insufficient. In accordance with the European Resuscitation Council guidelines, endotracheal intubation is the gold standard in airway management [2].
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Source Type: research
AbstractPurpose of ReviewIntubation of patients suffering acute traumatic injuries is associated with higher airway-related morbidity and mortality than when the same procedure occurs under elective conditions. Indirect video-enabled laryngoscopes (VL) offer the potential advantage of improved glottic visualization as an integral step in the process of endotracheal intubation when compared to traditional direct laryngoscopy (DL). However, despite robust evidence that VL consistently achieves a superior view of the vocal cords in critically ill and injured adults, a consistent improvement in first-attempt intubation success...
Source: Current Anesthesiology Reports - Category: Anesthesiology Source Type: research
More News: Airway Management | Brain | Emergency Medicine | Endotracheal Intubation | Hospitals | Laryngoscopy | Neurology | Respiratory Medicine | Statistics | Study